When does AFP concentration in the liver increase?

The article was professionally consulted by Specialist Doctor I Vo Thi Thuy Trang - Gastroenterologist, Department of Medical Examination & Internal Medicine - Vinmec Danang International Hospital. The doctor has many years of experience in the field of gastrointestinal endoscopy.

Alpha-fetoprotein (AFP) is a protein produced mainly by the liver when the body is still in its infancy or in the presence of liver damage such as cirrhosis or liver cancer. This property makes the AFP test useful as a tumor marker. Therefore, the information below may be useful for patients with chronic liver damage, knowing one more tool for early detection of this malignant complication.

AFP stands for alpha-fetoprotein. This is a protein made in the liver of a developing fetus. That's why AFP levels are usually high when a baby is born but drop very quickly when a child turns 1. In healthy adults, the level of AFP in the blood is very low.
Accordingly, the AFP tumor marker test is a blood test that measures AFP levels in adults. Suspected markers of tumor formation are detected indirectly through substances produced by cancer cells or by normal cells in response to tumor stimuli in the body. High AFP levels can be a sign of liver or ovarian or testicular cancer as well as advanced noncancerous liver diseases such as cirrhosis and hepatitis.
A high AFP level does not always mean a cancerous mass is present, and a normal level does not always rule out the possibility of this disease. Therefore, the AFP level test is not usually used to screen for or diagnose cancer. However, this marker can also help diagnose cancer when used in conjunction with other tests. In addition, the test can also be used to help monitor the effectiveness of cancer treatment and to periodically evaluate whether the cancer will return after you finish treatment.

AFP is used as a tumor marker to help detect and diagnose cancers of the liver, testicles, and ovaries.
Although this test is often indicated in routine follow-up in people with chronic liver disease such as cirrhosis, chronic hepatitis B or hepatitis C because these subjects are at high risk for liver cancer, Most current guidelines do not recommend the use of an AFP concentration test alone. Accordingly, the health care provider may order AFP tests along with imaging tests to try to detect liver cancer in a variety of ways while it is in its earliest and treatable stages. Okay.
If a person has been diagnosed with hepatocellular carcinoma or another AFP-producing cancer, an AFP test may also be ordered periodically to monitor the body's response. for treatment and monitoring of cancer recurrence.

A doctor will order a quantitative test of AFP blood levels when:
Suspect the patient has liver cancer or some other organ cancer such as testicles or ovaries A tumor is detected in the abdomen during examination or during imaging and suspicion of malignancy In patients who have been diagnosed and treated for liver, testicular, or ovarian cancer and are being monitored for treatment effectiveness Follow-up Cancer recurrence Follow-up of patients with chronic hepatitis or cirrhosis

Elevated AFP levels may indicate the presence of cancer, most commonly liver cancer, ovarian cancer, or germ cell tumors of the testicles. However, not all liver, ovarian or testicular cancers will produce a significant amount of AFP that is detectable in the blood.
A certain level of AFP can sometimes be seen in other cancers such as stomach, colon, lung, breast and lymphoma, although this test is rarely indicated in these cancers. reason above. In addition, it should be noted that other diseases such as cirrhosis and hepatitis can also cause an increase in AFP to some extent.
When AFP is used as a monitoring tool for malignancy, a decrease in blood levels indicates a good response to treatment. If the concentration after cancer treatment does not decrease significantly, usually to normal or close to normal, these cases will be considered as malignancies that can still occur. Likewise, if AFP levels start to rise again, it's likely that the cancer is coming back. However, because AFP can still be elevated in hepatitis or cirrhosis, this result can sometimes be misleading. On the other hand, if AFP levels have not been elevated immediately prior to treatment of the malignancy, testing is generally not useful for monitoring treatment efficacy or for later recurrence.
When the AFP levels of people with chronic liver disease go from normal or moderately elevated to very high, the risk of developing liver cancer increases. When the total AFP and AFP-L3% increase significantly, the person has an increased risk of getting or developing HCC over the next year or two.
Even so, not people with elevated AFP and AFP-L3% test results will develop cancer or will develop liver cancer. Instead, the diagnosis of malignancy depends on physical examination and other tests, including imaging that looks for tumor growth and tissue biopsies.

Furthermore, the AFP test can provide useful information, but its specificity is somewhat limited as it can be temporarily increased whenever the liver is damaged and regenerated. Also, not all cancers produce AFP; so a person can still get cancer even if AFP is normal. For these reasons, the AFP test should not be used to screen the general population for cancer.
Finally, it should be remembered that AFP is not just a tumor marker. Because AFP is also produced by a normal fetus, AFP levels are usually higher in pregnant women and in newborns.
In summary, AFP level test is often used as a tool to find malignancies in the liver, especially in high-risk subjects with hepatitis, cirrhosis, as well as to monitor progress. cancer progression. However, in order to evaluate the results, it is necessary to understand the factors when AFP levels in the liver are elevated in order to draw the most accurate conclusions.
Currently, Vinmec International General Hospital is implementing Packages for screening and early detection of liver cancer suitable for many subjects at risk of different diseases, including the package of liver cancer screening - developing liver cancer. Early detection of cancer without any symptoms. When registering for the package of screening and early detection of liver cancer, customers will receive:
Examination and consultation with an oncologist through an oncology appointment. Peripheral blood cell analysis. Assess liver function through tests such as measuring ALT activity (GPT), measuring AST activity (GOT), measuring GGT activity (Gama Glutamyl Transferase), measuring total bilirubin. Screening for hepatitis B and C virus infection through rapid HBsAg test and automatic immunological HCV Ab test. Screening for liver cancer through the quantitative test of AFP (Alpha Fetoproteine). Screening for liver tumors by abdominal ultrasound (general).

Currently, Vinmec International General Hospital is one of the medical facilities with a team of leading medical experts in the field of oncology, the most modern machinery and equipment in the region. Those will be good conditions to help the screening for early detection of liver cancer be quick, convenient and time-saving. As a result, it is possible to screen for liver cancer, helping to detect liver cancer at an early stage so that appropriate and timely treatment measures can be taken.

References: labtestsonline.org, urmc.rochester.edu, medlineplus.gov, webmd.com, healthline.com